Countryside Manor, Inc
LBN: Countryside Manor, Inc
Countryside Manor, Inc is an health care organization with primary practice located at 7700 Us Highway 158 , Stokesdale NC 27357-9346. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Assisted Living Facility is the primary health care specialty.
Countryside Manor, Inc can be contacted via phone (336) 643-6301, or through Stanleh, Miles E via phone (336) 643-6301.
Contact Information
Primary practice address
7700 Us Highway 158
Stokesdale NC 27357-9346
Phone: (336) 643-6301
Fax: (336) 643-9906
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Assisted Living Facility | 310400000X | NH0226 | North Carolina |
| Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility | 313M00000X | NH0226 | North Carolina |
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | NH0226 | North Carolina |
Profile Details
| NPI number | 1992790810 |
|---|---|
| LBN Legal business name | Countryside Manor, Inc |
| DBA Doing business as | |
| Authorized official | Stanleh, Miles E |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 16th, 2005 |
| Last updated | Aug 22nd, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992790810 | NPPES |
| North Carolina | MEDICAID | 3415390 | |
| North Carolina | MEDICAID | 3416145 |
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